Bruce Lewis, COTA

Individual provider Active NPI Occupational Therapy Assistant · Bridgeport, OH

NPI 1124677794 · NPPES record last updated Sep 6, 2019

Key facts

NPI
1124677794
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OTA5739 (OH)
Practice address
7 Cross St
Bridgeport, OH 43912-1435
Phone
(304) 281-3416
NPI assigned
Sep 6, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
OTA5739OHMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA5739 OH Yes

Addresses

Primary practice location

7 Cross St
Bridgeport, OH 43912-1435

Mailing address

7 Cross St
Bridgeport, OH 43912-1435

Other providers in Bridgeport, OH

All providers in Bridgeport, OH · Occupational Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.